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接受外固定治疗的骨科损伤患者的术后感染

Postoperative infection in patients undergoing inspection of orthopedic damage due to external fixation.

作者信息

Foni Noel Oizerovici, Batista Felipe Augusto Ribeiro, Rossato Luís Henrique Camargo, Hungria José Octavio Soares, Mercadante Marcelo Tomanik, Christian Ralph Walter

机构信息

Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, Brazil.

出版信息

Rev Bras Ortop. 2015 Oct 31;50(6):625-30. doi: 10.1016/j.rboe.2015.10.011. eCollection 2015 Nov-Dec.

DOI:10.1016/j.rboe.2015.10.011
PMID:27218072
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4867909/
Abstract

OBJECTIVE

To conduct a retrospective analysis on cases undergoing inspection of orthopedic damage, at an orthopedic emergency service in a teaching hospital, with the aim of evaluating patients with postoperative infection after conversion to internal osteosynthesis.

METHODS

This was a retrospective analysis covering the period from June 2012 to June 2013, on patients who underwent inspection of orthopedic damage due to external fixation and subsequently were converted to definitive osteosynthesis using a nail or plate.

RESULTS

We found an infection rate of 13.3% in our sample and, furthermore, found that there had been technical errors in setting up the fixator in 60.4% of the cases.

CONCLUSION

We found an infection rate that we considered high, along with inadequacies in constructing the external fixator. We emphasize that this procedure is not risk-free and that training for physicians who perform this procedure should be mandatory.

摘要

目的

对一家教学医院骨科急诊服务中接受骨科损伤检查的病例进行回顾性分析,旨在评估转为内固定术后发生感染的患者。

方法

这是一项回顾性分析,涵盖2012年6月至2013年6月期间因外固定接受骨科损伤检查并随后使用髓内钉或钢板转为确定性内固定的患者。

结果

我们在样本中发现感染率为13.3%,此外,还发现在60.4%的病例中存在外固定器安装技术错误。

结论

我们发现感染率较高,同时外固定器构建存在不足。我们强调该手术并非无风险,应对实施该手术的医生进行强制性培训。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2057/4867909/3b874816924d/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2057/4867909/1ca363c85c55/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2057/4867909/3b874816924d/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2057/4867909/1ca363c85c55/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2057/4867909/3b874816924d/gr2.jpg

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本文引用的文献

1
Treatment of Fractures of the Tibial Diaphysis Using External Fixator Compared with Locked Intramedullary Nails.使用外固定器与带锁髓内钉治疗胫骨干骨折的比较
Rev Bras Ortop. 2013 Jun 20;48(2):137-144. doi: 10.1016/j.rboe.2012.09.004. eCollection 2013 Mar-Apr.
2
The risk of local infective complications after damage control procedures for femoral shaft fracture.股骨干骨折损伤控制手术后局部感染并发症的风险。
J Orthop Trauma. 2006 Mar;20(3):181-9. doi: 10.1097/00005131-200603000-00004.
3
Pin tract infection with contemporary external fixation: how much of a problem?
当代外固定架针道感染:问题有多严重?
J Orthop Trauma. 2003 Aug;17(7):503-7. doi: 10.1097/00005131-200308000-00005.
4
State of the art review: techniques to avoid pin loosening and infection in external fixation.技术综述:外固定中避免钢针松动和感染的技术
J Orthop Trauma. 2002 Mar;16(3):189-95. doi: 10.1097/00005131-200203000-00009.
5
Fluid accumulation and the rapid spread of bacteria in the pathogenesis of external fixator pin track infection.外固定针道感染发病机制中液体蓄积与细菌的快速传播。
Injury. 2001 Jun;32(5):377-81. doi: 10.1016/s0020-1383(01)00008-0.
6
External fixation as a bridge to intramedullary nailing for patients with multiple injuries and with femur fractures: damage control orthopedics.对于多发伤合并股骨骨折患者,外固定作为髓内钉固定的桥梁:损伤控制骨科。
J Trauma. 2000 Apr;48(4):613-21; discussion 621-3. doi: 10.1097/00005373-200004000-00006.
7
Analysis of the external fixator pin-bone interface.外固定架针-骨界面分析
Clin Orthop Relat Res. 1993 Aug(293):18-27.
8
Chronic osteomyelitis in pin tracks.针道慢性骨髓炎
J Bone Joint Surg Am. 1984 Sep;66(7):1092-8.
9
Factors in pin tract infections.针道感染的相关因素。
Orthopedics. 1991 Mar;14(3):305-8.